Individual provider Active NPI

Brandon Michael Henkowicz, D.C.

  • Chiropractor
  • Stony Brook, NY
National Provider Identifier
1447514609
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X012178 Issued in NY
Practice address
2500 Nesconset Hwy BLDG 9B
Stony Brook, NY 11790-2553
Phone
(631) 689-0049
Fax
(631) 689-0071
NPI assigned
Jul 2, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X012178 NY Primary

Addresses

Primary practice location

2500 Nesconset Hwy BLDG 9B
Stony Brook, NY 11790-2553

Mailing address

2500 Nesconset Hwy BLDG 9B
Stony Brook, NY 11790-2553
Phone (631) 689-0049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161121002222 NY Practitioner - Chiropractic 6406167857 Reassigns benefits to 1 organization
Practice locations: Stony Brook, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2500 Nesconset Hwy
BLDG 9B
Stony Brook, NY 11790-2553
Phone (631) 689-0049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X012178NYMDChiropractor
012178NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
SB Holistic Hands LLC Current Accepting new patients
Brandon M Henkowicz DC, P.C. Chiropractor CurrentSince Jan 9, 2018 Accepting new patients

Locations

2500 Nesconset Hwy
Bldg 9B
Stony Brook, NY 11790
Phone (631) 689-0049

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1447514609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY BLDG 9B",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902553",
            "telephone_number": "631-689-0049",
            "fax_number": "631-689-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY BLDG 9B",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902553",
            "telephone_number": "631-689-0049",
            "fax_number": "631-689-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENKOWICZ",
        "first_name": "BRANDON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X012178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.